ILD for the rheumatologist: Digging through the past and making sense of the present

In this week's episode we interview Joseph Parambil, MD, staff member in the department of pulmonary, allergy and critical care medicine at Cleveland Clinic, about the current challenges of ILD, or interstitial lung disease. · Intro by Adam J. Brown, MD 0:12 · Welcome back Joseph Parambil, MD 0:32 · But first, some medical history on ILD 1:04 · ILD vs. IPF 2:26 · A quick aside into silicosis and bleomycin 4:27 · Trying to describe pulmonary fibrosis 5:23 · The different types of ILD 9:44 · Finding a slow progression of disease and autoimmune conditions 10:59 · Pulmonary fibrosis diagnoses in 1963 14:41 · The modern era of ILD 16:22 · Nonspecific interstitial pneumonia 20:12 · Handing things over to Dr. Parambil 23:01 · Helping rheumatologists understand ILD/The alphabet soup 24:34 · The shift from biopsies and using immunosuppression 33:07 · Is the workup similar for UIP and NSIP? 35:26 · Is there a standard protocol for workup in terms of serologies? 36:30 · The danger of choosing the wrong treatment 38:43 · Immunosuppression in patients with pulmonary hypertension and ILD 40:52 · UIP and ANCA vasculitis 42:12 · Compared to ten years ago, how are we doing with treatments? 43:10 · Where are we with lung transplants? 50:49 · Looking at hematopoietic stem cell transplants 53:24 · The importance of early diagnosis 54:14 · Antifibrotic medicines 56:15 · Chronic and acute interstitial lung diseases 58:41 · Thank you, Dr. Parambil 1:03:54 · A conclusion from Dr. Brown 1:04:20 · Thank you for listening 1:04:55 We'd love to hear from you! Send your comments/questions to Dr. Brown at [e-mail]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum. Joseph Parambil, MD, is a staff member in the Respiratory Institute and the director of the HHT Center of Excellence and the Vascular Anomalies Center at the Cleveland Clinic. He is associate professor of medicine at Cleveland Clinic's Lerner College of Medicine. He is certified by the American Board of Internal Medicine with additional specialty certification in pulmonary medicine and critical care medicine. References: Homolka J. CMAJ. 1987;PMID:3315158 Liebow A, et al. : "Frontiers of Pulmonary Radiology." The interstitial pneumonias, pp. 102-141. 1969. Grune & Stratton. Liebow A, et al. Calif Med. 1969;PMID:PMC1501512 Noble PW, et al. Am J Respir Cell Mol Biol. 2005;doi:10.1165/rcmb.F301 Scadding JG, et al. Thorax. 1967;doi:10.1136/thx.22.4.291 Disclosures: Brown and Parambil report no relevant financial disclosures.